F0676

E

Failure to Implement and Document Restorative Nursing Programs for ADLs

Canonsburg, Pennsylvania Survey Completed on 04-10-2026

Penalty

No penalty information released

Summary

The facility failed to provide and document restorative nursing services necessary to maintain residents' abilities in activities of daily living (ADLs), as required by its own "Restorative Nursing Program" policy and federal regulations. The policy stated that the facility would safely and effectively improve or maintain a patient's functional status or prevent deterioration. The Physical Therapy Director reported that restorative activities were to be documented on the daily "Restorative Nursing Care Flow Record." However, review of these flow records from January through March 2026 for multiple residents showed no documentation that the ordered restorative tasks were completed.

For one resident with a history of stroke and right-sided weakness, the care plan indicated a need for assistance with walking and transferring, and the restorative program specified walking 100 feet to dine with a wheeled walker and staff supervision, but there was no documentation of this being done. Another resident with Parkinson's disease required assistance with walking and was recommended to ambulate with staff and a wheeled walker; the restorative program also specified walking 100 feet to dine with supervision, yet no restorative care was documented. A third resident with quadriplegia and diabetes was dependent for all ADLs and had a therapy recommendation for lower extremity exercises and a restorative program for passive stretching of the right elbow, but again no restorative tasks were documented. A fourth resident with dementia, diabetes, and a history of falls, who walked with a wheeled walker and distant supervision, had a restorative program for assisted range of motion to all extremities, with no documentation of completion. A NA and the Physical Therapy Director both stated that restorative nursing was not being completed, and the Nursing Home Administrator confirmed that the facility failed to complete the restorative nursing program for these residents.

Plan Of Correction

Resident R24, R31, R78 and R93 will have a nurse/therapy evaluation to assess the restorative programs needed and POC task documentation will be created to ensure the program is completed by the CNA Resident recently discharged from Therapy will be assessed by both the Therapy department and Nursing for the need for any restorative programming. A POC task for documentation will be created to ensure the program is completed by the CNA.

Staff education will be provided by the DON/Designee on the Restorative programs and the needed documentation for the programs. Education will occur on orientation and yearly.

Audits will be completed by the DON/Designee on 10% of resident receiving restorative programs to ensure that the POC task documentation and the Nurse summary progress note are completed weekly times four onvarious shifts, then monthly timesthree months.Results of these audits will bepresented to the QAPI committee forreview and recommendations.